EFFICACY OF THE NATIONAL PROGRAM OF IRON SUPPLEMENTATION IN THE ANAEMIA CONTROL IN INFANTS ASSISTED BY CHILD EDUCATION CENTERS
DOI:
https://doi.org/10.7322/jhgd.88960Palavras-chave:
Iron deficiency anaemia, infants, supplementation with iron, ferrous sulphate, National Program of Iron Supplementation (PNSF).Resumo
Introduction: iron deficiency occurs in endemic proportion among hildren and is one of the causal factors of inappropriate cognitive, social, motor and reduced learning ability, putting infants as a priority group for nutritional intervention programs aiming to control iron deficiency. Thus, in 2005 the Ministry of Health established the National Program of Iron Supplementation (PNSF) available for the universe of children of 6-24 months old attended in Basic Health Units. Objective: to estimate the prevalence of anaemia and analyse the efficacy of profilatic supplementation with ferrous sufate. Methods: a prospective follow-up study intervention that was developed in the city of Guarujá – SP, Brazil in the universe of children between 6-24 months old attended in the Public Basic Health Units whose parents authorized their participation. The supplement was offered in accordance with the standards of PNSF and diagnosis of anaemia was performed before and 6 months after the intervention period. As a criterion for anaemia was used the standards of the World Health Organization that defines moderate anaemia to haemoglobin (Hb) between 11.0 and 9,5gHb/dL and severe anaemia to below 9,5gHb/dL. Results: a total of 136 children under two years, (81% of total) participated in the study. No statistically significant difference was found between the mean Hb concentration before and after the intervention period (p=0.684). The initial mean Hb was 11,6g/dL (SD=1.82) and the final 11.5g/dL (SD=1.31). Although only 11 of the 49 anemic reached normal values, 33 of them showed an increase in Hb concentration. Conclusion: there was an increase in Hb concentration among children with severe anaemia. There was no change in the situation of children with moderate anaemia. Supplementation with ferrous sulphate was not sufficiently effective in controlling iron deficiency in infants.
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Referências
International Nutritional Anaemia Consultative Group (INACG) Guidelines for the eradication of iron deficiency anaemia. New York, NY & Washington, DC: Nutrition Foundation, 1977 https://www.google.com.br/?gfe_rd=
ncr&ei=EoRaU9naI6Wj8we18oDgAg#q=International+Nutritional+Anaemia+Consultative+Group,+1977+DOI&spell=1.
Liu X-N, Kang J, Zhao L, Viteri FE. Intermittent iron supplementation in Chinese pre-school children is efficient and safe. FoodNutr Bull 1995; 16: 139-46. www.popline.org/node/300384.
BRASIL Ato Portaria Nº 730/GM em 13 de maio de 2005. Áreas de atuação. Alimentos. Legislação especifica da área por assunto. Programa Nacional de Suplementação de Ferro destinado a prevenir a anaemia ferropriva, http//www.saude.gov.br/nutricao/documentos/portaria_730_ferro.pdf].
Monteiro CA, Szarfarc SC, et al Long-term preventive mass prescription of weekly doses of iron sulphate may be highly effective. Food and Nutrition Bulletin, 22(1):53-60, 2001. https://www.google.com.br/?gfe_rd=c r & e i = t o Va U 6 P t I K K j 8 w e b s I F w # q =Food+and+Nutrition+Bulletin%2C+22(1)%3A53-60%2C+2001.
Brasil. Ministério da Saúde. Secretaria de Políticas de Saúde. Projeto para o controle da anaemiaferropriva em crianças menores de 2 anos nos municípios do Projeto de Redução da Mortalidade na Infância. Brasília: Ministério da
Saúde, 1998. 6p.
WORLD HEALTH ORGANIZATION (WHO). Iron deficiency anaemia: assessment, prevention and control. A guide for programme managers.Geneva, 2001 programme+managers. +Geneva%2C+2001.
Monteiro CA, Szarfarc SC. Estudo das condições de saúde das crianças no Municipio de Sâo paulo, SP,(Brasil), 1984-1985. V. Anaemia. Revista de Saúde Pública (SP) 1987, v.21,?gfe_rd=cr&ei=toZaU7zGG6yj8wfW3oG4Ag.
Horton S, Ross J. The economics of iron deficiency. Food Policy. 2003:28(1): 51-75. www.idpas.org/.../2206TheEconomicsofIronDeficie.
Granthan-MacGregor S. A review of studies on the effect of iron deficiency on cognitive development in children.J.Nut.2001. www.revistas.usp.br/jhgd/article/viewFile/20025/22111ý.
Szarfarc SC, Berg G, Santos ALS, Souza SB, Monteiro CAO controle da anaemia na infância atraves da rede báseica de saúde. J. Pediatria (RJ)72:329-34, 1996 https:/www.google.com.br/?gfe_rd=cr&ei=toZaU7zGG6yj8wfW3oG4.
de Souza OF, et al. Prevalence and associated factors to anaemia in children .J. Hum. Growth Dev. 2012;22(3):307-313.
Assis AMO, Gaudenzi EN, Gomes G, Ribeiro RC, Szarfarc SC, Souza SB. Níveis de hemoglobina, aleitamento materno e regime alimentar no primeiro ano de vida. Rev. Saúde Pública. 2004:38(4):543-51. http://www.scielo.br/pdf/rsp/v38n4/21084.pdf.
Szarfarcet al A concentração de hemoglobina no primeiro ano de vida da clientela de serviços públicos de saúde do Brasil. Cad. Saúde Pública, Rio de Janeiro, 2004;20(1):266-74. www.scielo.br/scielo.php?script=sci_
arttext...84842010000800002ý.
Frota MTBA. Prevalência e fatores associados à anaemia em mulheres e crianças no Maranhão. [Tese Doutorado]. Fac. Saúde Pública da USP, 2013. www.teses.usp.br/teses/disponiveis/6/6138/...08042013.../TerezaFrota.pdf.
Almeida CA, Ricco RG, Ciampo LA, Souza AM, Pinho AP, Oliveira JE. Factors associated with iron deficiency anaemia in Brazilian preschool children. J Pediatr (Rio J). 2004 May-Jun; 80(3):229-34.
Torres MAA et al. Anaemia em crianças menores de dois anos atendidas nas unidades básicas de saúde no Estado de São Paulo, Brasil. Revista de Saúde Pública, São Paulo, 1994; 28: 290-4. www.scielo.br/scielo.php?pid=S0034-89102001000100010&script...
Monteiro CA, Mondini, L e Szarfarc, SC. Tendência secular da anaemia na infância na cidade de São Paulo (1984-1996). Revista de Saúde Pública, São Paulo, v. 34, n.6, p. 62-72, 2000. www.scielo.br/scielo.php?script=sci_arttext...89102000000700003.
Torres, MAA. Programa de fortificação do leite pasteurizado e de atividades de educação em saúde e nutrição, na prevenção e recuperação da anemia carencial ferropriva, em crianças menores de dois anos. São Paulo, 2000. Tese de Doutorado. Centro de Referência da Saúde da Mulher e de Nutrição, Alimentação e Desenvolvimento Infantil - Secretaria da Saúde do Estado de São Paulo. www.scielo.br/scielo.php?script=sci_arttext&pid=S1516...
Alleo LG, Souza SB, Szarfarc SC. Feeding practices in the first year of life, Journal of Human Growth and Development, 24(2): 195-200. www.revistas.usp.br/jhgd/article/viewFile/81222/86109.
Augusto RA, Souza JMP. Crescimento de crianças em aleitamento materno exclusivo no primeiro semestre de vida. Rev Bras Crescimento Desenvolv Hum 2007; 17(2):01-11 www.revistas.usp.br/jhgd/article/download/19827/21899.
Parada CMGL, Carvalhaes MABL, Jamas MT. Práticas de aalimentação complementar em crianças no primeiro ano de vida. Rev Latinoam Enfermagem 2007 março-abril; 15(2). http://www.scielo.br/pdf/rlae/v15n2/pt_v15n2a14.pdf.
Bernardi JLD, Jordão RE, Filho AAB. Alimentação complementar de lactentes em uma cidade desenvolvida no contexto de um país em desenvolvimento. Rev Panam Salud Publica 26(5), 2009. http://www.scielosp.org/pdf/rpsp/v26n5/04.pdf.
Torigoe CY, Asakura L, Sachs A, Silva CVD, Abrão ACFV, Santos GMS, Coelho LC. Influência da orientação nutricional nas práticas de alimentação complementar em lactentes.
J.Human Growth and Development 2012;22:1-11. www.revistas.usp.br/jhgd/article/download/20055/22169.
Vieira GO, Silva LR, Vieira TO, Almeida JAG, Cabral VA. Hábitos alimentares de crianças menores de 1 ano amamentadas e não amamentadas. J Pediatr (RJ). 2004;80(5):411-6. http://www.scielo.br/pdf/jped/v.80n5/v80n5a13.pdf.
Simon VGN, Souza JMP, Souza SB. Introdução de alimentos complementares e sua relação com variáveis demográficas e socioeconômicas, em crianças no primeiro ano de vida, nascidas em Hospital Universitário no município de São Paulo. Rev. Bras. Epidemiol. Vol.6, No1, 2003. http://www.scielosp.org/pdf/rbepid/v6n1/05.pdf.
Assis AMO, Gaudenzi EN, Gomes G, Ribeiro RC, Szarfarc SC, Souza SB. Níveis de hemoglobina, aleitamento materno e regime alimentar no primeiro ano de vida. Rev. Saúde Pública. 2004:38(4):543-51. http://www.scielo.br/pdf/rsp/v38n4/21084.pdf.
LINCH, SR The impact f iron fortification on nutritional anaemia. Best Practica& Research Clinical Haematology v.18, n.2.p.333-46, 2005) https://www.google.com.br/?gfe_rd=cr&ei=toZaU7zGG6yj8wfW3oG4Ag#q=.+LINCH%2C+SR.
Brasil. Ministério da Saúde. Centro Brasileiro de Análise e Planejamento. Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher. PNDS, 2006. Brasília. DF, 2009 www://bvsms.saude.gov.br/bvs/publicações/pnds.crianca mulher.pdf.
Levy-Costa RB, Monteiro CA. Consumo de leite de vaca e anaemia na infância no Município de São Paulo. Revista de Saúde Pública, 2004: 38,797-803. www.scielo.br/scielo.php?pid=0034-891020040003&script=sci.
Batista Filho M, Souza AI, Bresani CC Anaemia como problema de saúde pública. Ciência e Saúde Coletiva, 2008; 13(6). www.redalyc.org/pdf/630/63013624.pdf.
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